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Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases are presented and analyzed in which a Lippman Transfixion Hip Prosthesis had to be replaced because of the discomfort of the patient. In each case, there was evidence of wear between the head of the prosthesis and the flange. The different wear patterns indicated problems which exist in the alignment of component parts of the prosthesis. In each case there was low grade sepsis to which the debris may have contributed. Because of phagocytosis, amount of debris accumulation was difficult to evaluate. The factors which appear to have contributed to the amount of debris accumulation were: the length of time the prosthesis had been used; the degree of alignment and amount of debris which may be formed and is phagocytized; the degree of manufacturing control. The design of this prosthesis incorporated mechanical problems which are generally undesirable because of: the eventual deformation of the end of the pivot rod or hole in the head of the prosthesis: progressive loosening of the movement due to this and inherent malalignment; the difficulty in fabrication, assembly and installation of the prosthesis because of the multiplicity of parts; the difficulty in maintaining adequate control of surface finishes.
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PMID:Biomechanical considerations of multiple-component hip prostheses. Analysis of three failures of the Lippman transfixation hip prosthesis. 112 66

The therapeutic concept for proximal femur fractures has changed to varying degrees from 1978 to 1988 in the Department of Traumatology and Reconstructive Surgery at Steglitz Medical Center. In general, conservative therapy has been abandoned. Alloplastic joint replacement is performed in patients with coxarthrosis in the fracture area. A head prosthesis is chosen for those with a life expectancy of less than eight years. Clearly favourable results have been achieved in our department with the Duokopf prosthesis. Patients with a higher life expectancy are submitted to a total hip endoprosthesis, preference being given in cases of collum femoris fractures to the combination of a Spotorno shaft and a Morscher acetabulum. Loading should only be partial for five weeks in patients treated with this cement-free total endoprosthesis. We use the Duokopf prosthesis in the combination of a Spotorno shaft with a Uni-Hip head. We submit these patients to full loading primarily. --We have completely abandoned Ender nailing. We prefer the dynamic hip screw for per- and intertrochanteric femur fractures. For subtrochanteric femur fractures, we use the condyl plate. For lateral collum femoris fractures we have used the four-hole angle plate until 1988. Since 1989 we also use the dynamic hip screw. The one-hole angle plate is used for osteosynthesis in cases of medial collum femoris fractures.
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PMID:[Developments in the treatment of fractures of the coxal end of the femur]. 257 55

Eight consecutive patients, mean age 17.25 years, underwent a medial displacement osteotomy and hip arthrodesis with a nine-hole Cobra plate. A transverse innominate osteotomy facilitated medial displacement of the femoral head and acetabulum. Alignment of the lower limb at 25 degrees flexion, neutral abduction, and neutral rotation was assisted by a long-limbed protractor and Steinmann pins placed in both anterior superior iliac spines. The greater trochanter was reattached to the Cobra plate so that hip abductor function could be restored should the fusion ever be converted to an arthroplasty. No postoperative immobilization was required. All patients had radiographic evidence of union by 12 months. One patient had a postoperative brachial plexus neuropraxia that resolved at three months. One patient required an ipsilateral femoral lengthening for limb-length inequality secondary to collapse of his femoral head before hip fusion. At a mean follow-up interval of 2.8 years (range, one to 4.5 years), all patients had significant improvements in pain (p < 0.05), function (p < 0.01), and gait (p < 0.01). The average preoperative Harris Hip Score of 45 points +/- 8 points (mean +/- SEM) improved to 84 points +/- 2 points (p < 0.01).
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PMID:Hip fusion in young adults. Using a medial displacement osteotomy and cobra plate. 813 27

Advancement or separation of the apex hole eliminator screw in uncemented Duraloc 100 cups (DePuy, Warsaw, Indiana, USA) has been recently reported as a radiographic finding without clinical effects. We report 4 patients with a separation of the apex hole eliminator screw in Duraloc 300 uncemented cups and aseptic failures of a hybrid total hip arthroplasty (acetabular osteolysis and femoral stem loosening). Revision surgery was performed when disabling pain and radiographic signs of loose components were present. Although difficult to determine, a relationship between the screw migration and the failure could have existed in these cases. Migration of the screw might not only be interpreted as a radiographic, clinically irrelevant finding. Its presence should alert the orthopaedic surgeon that the prosthesis is exposed to high intraarticular fluid pressures.
Hip Int
PMID:Separation of the apex hole eliminator screw in four failed hybrid total hip arthroplasties. 1919 42

Internal snapping often resolves with conservative treatment but persistent significant symptoms may require surgical treatment. Different surgical approaches have been suggested in the literature with varying results. We describe a modified surgical approach for internal snapping of hip in adults with good results. Patients who failed conservative treatment for internal snapping over 11/2 years were included. A skin crease incision was made just lateral to the ASIS in supine position. The psoas tendon was reached sub-periosteally along the internal iliac surface and a hole was made in periosteum. Then the tendon was hooked into the wound and divided releasing its musculotendinous junction. The patients were allowed to mobilise as able in the postoperative period. There were 8 snapping hips (7 patients, 6 females) with average age of 30 years (17-51 yrs). The mean follow-up was 11 months. The average duration of symptoms before operation was 4.5 years (range 2-10 years). Painful symptomatic clicking was relieved in all patients. Two patients felt slight weakness of hip flexion. One patient had temporary neuropraxia of lateral cutaneous nerve of thigh. The diagnosis is made by ultrasound or examination for a palpable click. Surgical correction of snapping is considered after failure of conservative treatment. Different extrapelvic (medial and iliofemoral) and intrapelvic extraperitoneal approaches have been described with varying results. With our slightly modified intrapelvic and subperiosteal approach through oblique inguinal incision in adults, psoas muscle release at musculotendinous junction seems a safe and effective method and could be used as an alternative surgical approach for treatment of internal snapping of hip in adults.
Hip Int
PMID:Clinical outcome following a modified approach for psoas lengthening for coxa saltans in adults. 1919 60

The highly cross-linked polyethylene liners currently used with modular uncemented cups have substantially decreased wear and osteolysis at early follow-up. However, retroacetabular osteolysis has still been reported in some cases with DePuy Orthopaedic's (Warsaw, IN) second-generation Duraloc acetabular shell. DePuy's third-generation Pinnacle cup incorporates a different shell-liner locking mechanism. We compared the clinical outcome among a matched series of 42 Duraloc and 42 Pinnacle cups at a mean follow-up of 5.9 years. Although the Harris Hip Scores and wear rates were not statistically different between the 2 cup designs, retroacetabular osteolysis behind the central hole was absent among the Pinnacle cups but noted among 19% of the Duraloc cups.
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PMID:A comparison of a second- and a third-generation modular cup design: is new improved? 1936 49

Osteoporotic hip fractures are common in our setting. Poor bone quality favors complications of the osteosynthesis procedures used to treat these patients. Lag-screw cut-out through the femoral head is not uncommon (2%), but pull-out of side plate screws is very unusual. We present the case of a patient with a stable osteoporotic fracture treated by osteosynthesis using a four-hole plate, who presented with a pull-out following a low-energy fall.
Hip Int
PMID:Unusual case of osteosynthesis failure in a hip fracture: side-plate pull-out. 2004 92

Current evidences in revision hip arthroplasty suggest to treat severe acetabular bone loss with dedicated implants, such as anti-protrusio cages, stemmed cups, modular systems supplied with iliac flanges and obturatory hook. However recent literature is reporting satisfactory outcomes with simple elliptical Trabecular Metal cups. Purpose of the study was to evaluate mid-term results of such a surgical procedure. All hip revisions performed from 2008 to 2009 with implantation of a TMT multi-hole acetabular cup without augmentations were retrospectively reviewed. The cases with low-degree acetabular bone loss (stage I and II according to GIR classification), with surgical report poorly describing the bone defect, with inadequate pre- and post-operative x-rays were ruled out. Twenty-five cases were identified, but four were lost to follow-up. The twenty-one patients were 71 year-old on average (from 60 to 82), with stage IV bone loss in 6 cases and stage III bone loss in 15 cases. Mean interval from surgery to evaluation was 20.9 months (from 13 to 30). The evaluation included bone-prosthesis contact estimation, component position, survivorship, complications, final Harris Hip Score, presence of periprosthetic radiolucencies. Host bone-prosthesis contact was estimated to be about 35%. Only three implant were subsequently reoperated (for infection, early migration, recurrent dislocation). The HHS among non-reoperated 18 patients was 81.96 on average (from 63.44 to 95.82). Six cases showed thin radiolucencies in one of the three Charnley zones, while three cases showed radiolucencies in two. None of these images was evolutive, thus they were not considered signs of loosening. The mid-term results of this series confirm the hypothesis that a porous tantalum acetabular cup is an effective option to deal with difficult acetabular revisions. Although no extra-acetabular fixation device is available, the very high surface friction guaranteed by the material and the supplemental stability provided by trans-acetabular screws seem to be sufficient to allow satisfactory reimplantation even in severely damaged pelves.
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PMID:Trabecular metal cup without augments for acetabular revision in case of extensive bone loss and low bone-prosthesis contact. 2166 52

The 'cement in cement' technique for revision hip arthroplasty has become popular in recent years, particularly in relation to polished taper stems. Since 2006 a short Exeter stem with 44 mm offset has been available specifically for this purpose. We report a fracture of such a stem in the absence of trauma 5 years after the revision procedure. The patient had a BMI of 27.8 and the proximal cement mantle gave good support to the stem. The fracture initiated and propagated from the introducer hole on the shoulder of the prosthesis. Macroscopically there was no defect in this area. This may be an unusual case of fatigue failure.
Hip Int
PMID:Fracture of an Exeter 'cement in cement' revision stem: a case report. 2194 33

Hip resurfacing is a popular procedure among patients and surgeons. The principal concepts of hip resurfacing are simple, yet demanding, as the procedure has limited tolerance to placement errors, especially for the femoral component. In current technical manuals, the placement of a guide wire seated in the neck is crucial. This guide wire is usually applied by the use of jigs that are intended to align to the neck axis. After evaluating the position of the guide wire, it is necessary to reposition it in many cases. We propose the use of a specially designed readjustment jig that takes advantage of the first guide wire, and gives defined offset and angulations for the placement of a second guide wire. A simple set of disks with different offsets and angulations in relation to a central hole has been developed to serve as a tool to readjust the positioning of the central guide wire in hip resurfacing.
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PMID:A simple tool for the adjustment of the guide wire position in hip resurfacing. 2306 3


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